Articles: postoperative-complications.
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With estimated global postoperative mortality rates at 1% to 4% leading to approximately 3 million to 12 million deaths per year, an urgent need exists for reliable measures of perioperative risk. Existing approaches suffer from poor performance, place a high burden on clinicians to gather data, or do not incorporate intraoperative data. Previous work demonstrated that intraoperative anesthetics induce prefrontal electroencephalogram (EEG) oscillations in the alpha band (8 to 12 Hz) that correlate with postoperative cognitive outcomes. ⋯ Intraoperative EEG alpha power is independently associated with postoperative mortality and adverse outcomes, suggesting it could represent a broad measure of postoperative physical resilience and provide clinicians with a low-burden, personalized measure of postoperative risk.
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Prospective longitudinal comparative cohort. ⋯ Predictive hemodynamic monitoring to manage intraoperative hemodynamic instability is associated with a shorter duration of intraoperative hypotension, a lower prevalence of complications, and a decreased hospital stay in multi-level spinal fusion surgery.
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Comparative Study
One-Level versus Two-Level Anterior Lumbar Interbody Fusion (ALIF) from L4-S1: Comparison of Complications, Alignment, and Patient Outcomes.
Retrospective cohort study. ⋯ Level IV.
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To evaluate the efficacy of non-fixation versus fixation of meshes in laparoendoscopic repair of M3 inguinal hernias in terms of recurrence, postoperative pain, and surgical complications. ⋯ Non-fixation of three-dimensional meshes is non-inferior to fixation of flat lightweight meshes for M3 inguinal hernia repair. These findings support the potential revision of international hernia management guidelines to incorporate non-fixation approaches with appropriate mesh types.
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To investigate the association between glycemic control, measured by glycated hemoglobin (HbA1c) levels, and post-operative complications across various procedures, identify the prevalence of patients with undiagnosed prediabetes or diabetes undergoing surgery, and explore whether better glycemic management is associated with reduced short-term postoperative complications. ⋯ Glycemic control significantly impacts morbidity and mortality in surgical patients. A total of 23% of patients were patients with undiagnosed prediabetes or diabetes, underscoring the importance of preoperative HbA1c screening for all patients. Both very low and very high HbA1c levels should be preoperatively addressed, with moderate control (HbA1c 7-8%, 53-64 mmol/mol) identified as optimal. Overall, these findings emphasize the need for personalized diabetes management plans tailored to each patient's needs and should inform clinical guidelines.